Grant, Gregory
Grant, Gregory is an individual health care provider with primary practice located at 3214 Kethley Rd , Shawnee OK 74804-9625. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Grant, Gregory can be contacted via phone (405) 273-5801.Contact Information
Primary practice address
3214 Kethley Rd
Shawnee OK 74804-9625
Phone: (405) 273-5801
Fax: (405) 878-3814
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 25087 | Oklahoma |
Profile Details
| NPI number | 1609918234 |
|---|---|
| LBN Legal business name | Grant, Gregory |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Aug 30th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609918234 | NPPES |
| Oklahoma | MEDICAID | 200124950A |
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